Stimulants vs. Non-Stimulants: Understanding ADHD Medications
ADHD medications generally belong to one of two broad classes: stimulant or nonstimulant. Learn the important differences, in this video.
EDITORS’ NOTE: The video above was created in 2018 and does not include all currently available stimulant and non-stimulant medications used to treat ADHD. The ADHD Medication Guide, developed and maintained by Dr. Andrew Adesman, comprises a comparison chart of FDA-approved stimulants and non-stimulants that is updated more frequently.
As many as 6.1 million children in the United States (9.4%) between ages 2 to 17 are estimated to have attention deficit hyperactivity disorder (ADHD or ADD), according to a 2016 study from the Centers for Disease Control and Prevention (CDC).1
Luckily, there are safe, effective treatments.
The best ADHD treatment strategies are multimodal ones — combinations of several different, complementary approaches that work together to reduce symptoms. This ideal combination includes behavioral therapy, nutritional changes, exercise, meditation, and/or medications for many people.
From years of research and many studies, experts know that medications are effective. They improve the core symptoms of ADHD — impulsivity, hyperarousal, and distractibility.
But how do you know which medication is right for you? Start by watching this video.
Stimulants vs. Non-stimulants: Understanding ADHD Medications
ADHD medications generally belong to one of two broad classes: stimulant or non-stimulant.
Stimulants include brand names like Adderall, Vyvanse, Ritalin, Concerta, and Jornay PM. Non-stimulants include Strattera, Qelbree and Intuniv, among others. So what are the important differences?
1. Stimulants
The stimulant class of medication is typically prescribed first because it works for 70-80% of children with ADHD.2
Stimulants increase dopamine and norepinephrine levels between the brain’s synapses. They work as soon as they cross the blood-brain barrier, which takes 45 to 60 minutes. The result? Reduced hyperactivity, distractibility, and/or impulsivity.
All of the FDA-approved stimulant medications use one of only two molecules: methylphenidate or amphetamine.
The best choice hinges on an individual’s biochemistry. Even family members may experience different results with the same medication.
2. Non-stimulants
For 20-30% of people with ADHD, stimulants do not work. They move on to try one of these FDA-approved non-stimulants:
- Strattera (atomoxetine)
- Kapvay (clonidine)
- Intuniv (guanfacine)
- Qelbree (viloxazine)
Assessing the full benefits of a non-stimulant medication often takes seven days to several weeks.
Sustained focus, improved mood, greater attention to detail, better memory, better sleep, and reduced impulsivity are all signs the treatment is working.
How do you choose the best option?
“Just as nothing predicts in advance which molecule will be best for a given child, it turns out that nothing predicts the dose of medication either: not body mass, height, gender, ethnicity, or the severity of symptoms,” says ADHD specialist William Dodson, M.D. The answer: experimentation and patience.
Source
1 Melissa L. Danielson, Rebecca H. Bitsko, Reem M. Ghandour, Joseph R. Holbrook, Michael D. Kogan & Stephen J. Blumberg. (Jan. 24, 2018). Prevalence of Parent-Reported ADHD Diagnosis and Associated Treatment Among U.S. Children and Adolescents, 2016. Journal of Clinical Child & Adolescent Psychology, 47:2, 199-212, DOI: 10.1080/15374416.2017.1417860. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5834391/pdf/nihms937906.pdf
2 Advokat C, Scheithauer M. Attention-deficit hyperactivity disorder (ADHD) stimulant medications as cognitive enhancers. Front Neurosci. 2013 May 29;7:82. doi: 10.3389/fnins.2013.00082.
